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经颅多普勒超声(transcranial Doppler,TCD)是一项安全有效的超声检查。影像检查在显示血管结构的同时亦可描绘颅内血流状况,但经颅彩色双功能超声(transcranial color-coded duplex sonography,TCCS/TCCD)和传统TCD最终是通过频谱波形分析来评估血流的生理学特征。多学科专家小组制定的TCD临床适应证包括:镰状细胞疾病、脑梗死/短暂性脑缺血发作(transient ischemic attack,TIA)、右向左分流(right-to-left shunts,RLS)、蛛网膜下腔出血、脑死亡、围手术期及术中监测。住院及门诊的临床实践中需遵循的TCD规程为:部分或完整的TCD检查,以探查颅内血管是否存在狭窄、闭塞以及侧支循环的情况;完善颈部血管彩色超声及无创血管影像结果;血管舒缩反应性检测识别首发或复发卒中的高危患者;栓子监测实时发现、定位及量化栓塞形成;对可疑反常性栓塞及拟采用封堵术治疗的患者进行RLS检测;溶栓中监测以促进血管再通及发现再闭塞;血管内支架置入术、颈动脉内膜剥脱术、心脏手术中监测能发现围手术期栓塞、血栓形成、灌注不足及过度灌注。上述标准规定了TCD的应用范围,可作为医生或第三方开据检查、评估及应用检查结果的参考。
Transcranial Doppler (TCD) is a safe and effective ultrasound examination. Imaging shows intracranial blood flow while displaying vascular structures, but transcranial color-coded duplex sonography (TCCS / TCCD) and conventional TCD ultimately assess blood flow through spectral waveform analysis Physiological characteristics. TCD clinical indications developed by a multidisciplinary team of experts include: sickle cell disease, cerebral infarction / transient ischemic attack (TIA), right-to-left shunts (RLS), cobweb Subdural hemorrhage, brain death, perioperative period and intraoperative monitoring. TCD procedures to be followed in clinical practice of inpatients and outpatients are: partial or complete TCD examination to explore the existence of stenosis, occlusion and collateral circulation in intracranial blood vessels; improve the results of color ultrasound and non-invasive vascular imaging of the neck; Vasoconstrictive reactivity testing identifies high-risk patients with a first-episode or recurrent stroke; emboli monitoring detects, positions, and quantifies embolic events in real time; RLS tests are performed on patients with suspected anomalous embolism and intended closure therapy; Promote revascularization and find occlusion; endovascular stenting, carotid endarterectomy, cardiac surgery can detect perioperative embolism, thrombosis, hypothyroidism and over-perfusion. The above standard specifies the scope of application of TCD, which can be used as a reference for examining, assessing and applying examination results by doctors or third parties.